Moxibustion for breech presentation

There is evidence to suggest that moxibustion may be useful for turning babies from breech presentation (bottom first) to cephalic presentation (head first) for labour when used with either acupuncture or postural techniques of knee to chest or lifting buttocks while lying on the side.

Breech presentation of babies is common in the second trimester of pregnancy but most babies turn themselves before the onset of labour; some do not. A baby coming bottom first can have more difficulty being born, which causes trauma to the mother. A vaginal birth has to be planned or a caesarean section may be suggested.

Moxibustion is a type of Chinese medicine that may be helpful in turning a breech baby. It involves burning a herb close to the skin at an acupuncture point on the little toe to produce a warming sensation. This review found eight randomised controlled trials involving 1346 women. Women randomly assigned to moxibustion had daily to twice weekly treatment at between 28 and 37 weeks. In one trial adverse events relating to treatment included an unpleasant odour (with or without throat irritation), nausea and abdominal pain from contractions. The included trials were of moderate methodological quality, sample sizes in some of the studies were small, how the treatment was applied differed and reporting was limited. While the results were combined they should be interpreted with caution due to the differences in the included studies. More evidence is needed concerning the benefits and safety of moxibustion.

Be noted:

This review found limited evidence to support the use of moxibustion for correcting breech presentation. There is some evidence to suggest that the use of moxibustion may reduce the need for oxytocin. When combined with acupuncture, moxibustion may result in fewer births by caesarean section; and when combined with postural management techniques may reduce the number of non-cephalic presentations at birth, however, there is a need for well-designed randomised controlled trials to evaluate moxibustion for breech presentation which report on clinically relevant outcomes as well as the safety of the intervention.

Resource: Cochrane